Articles by Dr. Patrick

Riding the fall line: snowboarding safely

In my last article I described the vulnerability of the knee joints in this dynamic sport, and suggested that warming-up, stretching, muscle strengthening and proper technique can help to prevent injuries.

Snowboarding, which these days many skiers participate in as well as skiing, presents a different trend of injury patterns than skiing. Where skiers more frequently injure the lower body, two thirds of all snowboarding injuries are to the upper limbs. Anyone who has tried snowboarding discovers pretty quickly that there’s not much of a middle ground when it comes to falling: when you’re down, you’re down, and you don’t have poles or the ability to put your foot out to break your fall. Instead, the snowboarder often absorbs a fall with the hands and arms, leading to a common problem: fall on outstretched hand, or FOOSH injuries. FOOSH injuries in general are by no means unique to snowboarding, and indeed “skiers thumb” results when ski pole straps get in the way. But in snowboarders sprains and fractures to the wrist and forearm are ten times more common than in skiers. Shoulder dislocation and clavicle fracture are also a risk when your arms take the brunt of a fall.

Lower limb injuries are much less common in snowboarding, because with the board fixed to both feet, it can’t act as an independent lever. The most common lower limb injuries seen in snowboarders are to the leading ankle, often from rough landings from a jump. It is jumping, in fact, that is to blame for most injuries to intermediate snowboarders. In comparison, jumping injury rates are significantly higher than from collisions, despite what some might think of snowboarders’ compromised visibility. Jumping injuries can be simple ankle or wrist sprains, but jumping is also the most common cause of devastating spinal or head trauma. While more jumping injuries are being seen with skiers as freestyle and aerial skiing gains in popularity, the prevalence of spinal and head injuries in skiing is still one quarter of that seen with snowboarding.

So how can these injuries be prevented? There is no ultimate answer to that, but certainly there are things you can do to help. While there is little evidence to demonstrate significant injury prevention with them, wrist guards and helmets are your best defence against wrist and head injuries. Wrist guards help prevent hyperextension and compression forces on the wrists, especially with common and repetitive insults such as when sitting down to do up bindings, or with minor falls. Of course, in harder falls any forces dissipated from the wrist have to go somewhere, and some argue wrist guards can put more stress on the shoulders in falls. Helmets, too, are not without controversy, and it has been suggested their use makes the wearer feel less vulnerable and may increase risk-taking behaviour. Despite this, it seems to me that if either of these devices are worn with their limitations in mind, they can be effective protection against common injuries. Helmets, in particular, have gained in popularity in recent years, for both skiers and snowboarders. Like bicycle helmets, as more people wear them they become more socially acceptable, and despite an initially higher financial investment, a new, lightweight helmet is as or more comfortable and warm as a toque, so you might as well put one on.

The single best injury prevention method can be realized by looking at some statistics: in snowboarding, the risk of injury is eight times higher in beginners, with 40 to 60 percent of beginner snowboarders being injured, up to 72 percent of those in the first day! While these numbers are unsettling, it can be argued that if you are going out to learn to snowboard, taking your time with it, realizing your limitations, and learning some proper technique so that you can stay in control and avoid dangerous situations would help you to avoid becoming one of these statistics.

Finally, all of these injuries are worth being aware of and trying to avoid, but don’t let this scare you away from these fun sports. Overall, most snowboarders and skiers enjoy the hills without incident. Most common “injuries” are relatively minor, such as back pain from sustained forward flexion with skiing, or neck pain from rotating the head to look over the lead shoulder in snowboarding. As with skiing, taking an active role in keeping the muscles and joints you’ll use in snowboarding strong and flexible is always advisable. If you do notice some pain during or after activity, seek some conservative treatment to solve the problem before it progresses or becomes a chronic issue that may prevent you from enjoying the slopes.

No sports are without some risks, and the benefits attained from enjoying physical activity in the winter far outweighs alternative of hibernating until the spring.